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I felt the need to write in response to an item contained in Paediatrics & Child Health. The publication contains an excellent review of enuresis (Paediatr Child Health 1997;2:419–21,423–425). It is followed by a handout on the same subject (Paediatr Child Health 1997;2:422,426).
My concern is with the comic strip section of the handout and specifically with the last frame in which Winston, the enuretic owl, “realizes that he has made a mistake” when he wakes up wet in the morning. I think the choice of the word “mistake” is unfortunate. Indeed the message in the article and handout is that this is a physiological event not under the conscious control of the sleeping child. To suggest that nocturnal enuresis is a “mistake” implies wrongdoing, albeit perhaps an inadvertent wrong choice. That negative connotation can contribute to the poor self-esteem which is a most serious complication of enuresis.
I wonder if the publication would consider modifying the handout and republishing it. To paraphrase the Great Bard, “Owl’s well that ends well”.
I read with appreciation your comments about the Canadian Paediatric Society Clinical Practice Guideline on enuresis. It is thanks to the observations of our colleagues that we can improve in our endeavours. As you can see your comments served to improve the message conveyed in the comic strip section (see pages 141–142 for a reprint of A Note from the Doctor).
I greatly appreciate your time in giving us feedback.